Musings in the life of an internist, cardiologist and cardiac electrophysiologist.

Tuesday, April 17, 2007

Dear Patient: P4P is Here

Dear Mr. and Ms. Patient,

I regret to inform you that I will be spending less time focusing on your heart problem because I have decided to focus on the heart and medical problems that Medicare deems important to assure I get paid. They call this initiative "Pay for Performance (P4P)."

You see they published a list of 74 criteria that will be measured to see if I give good care, so I will get paid appropriately. Fortunatelty for cardiologists, we only have to do four things:

And the specifications for how we should do this providing and documenting good care can be found here (Caution, this pdf file is 181 pages long!).

So, dear patient, I'm sorry if you have pericarditis or heart block. I'm gonna need to focus on my heart attack and heart failure patients a bit more to make sure my office staff can still return your calls.

The point here is not to take anything out on patients - that is the farthest thing any doctor wants to do. But where are the prospective studies that have demonstrated that any such "performance" initiatives have actually improved patient care?

My colleague put it best. "It's not pay for performance. On the contrary, it's under-payment that rewards minimal performance."

About Me

Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist (doctor specializing in heart rhythm disorders) practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine. He entered the blog-o-sphere in November, 2005.
DISCLAIMER: The opinions expressed in this blog are strictly the those of the author(s) and should not be construed as the opinion(s) or policy(ies) of NorthShore University HealthSystem, nor recommendations for your care or anyone else's. Please seek professional guidance instead.